REPUBLIC OF THE PHILIPPINES)

CITY OF ..........................................)

AFFIDAVIT OF DESISTANCE

I, _____________, of legal ages, Filipino, (single / married / widow), and a

resident of _____________, Philippines, after having been duly sworn in accordance with
law, hereby depose and say:

That I am the private complainant in the criminal case entitled "_____________"

for _________________ docketed as _____________ before _____________ Trial
Court, Branch _______, _____________ City, Philippines;

That after a thorough analysis of my memories of the incident that occurred on

_____________________________, I have realized that I cannot point out, beyond
reasonable doubt that the accused _____________, committed the above stated crime of
_____________ on ____________________, as it was too dark to discern the features of
the perpetrator with any degree of certainty;

Since I could not state with certainty and without doubt the liability of the accused
____________________, I feel compelled to withdraw my complaint against him and I
clear him of whatever responsibility or liability to me;

That in view of the foregoing, I finally manifest that I now completely and
absolutely exonerate the accused _____________ from any liability in connection with
the above-mentioned criminal case and that I am no longer interested, and I hereby desist,
in prosecuting the said criminal case;

That I execute this Affidavit of Desistance so that the above-mentioned criminal

case be immediately dismissed and considered finally closed and the bond posted by the
herein accused be released to him;

As such, I respectfully pray that the aforementioned case against the Accused
_____________ be dismissed and finally closed.

IN WITNESS WHEREOF, I have hereunto set my hand this _____________ at

_____________ City, Philippines.

Affiant

JURAT